双氯芬酸钠栓超前镇痛治疗小儿术后疼痛的研究

Study of Preemptive Analgesia with Diclofenac Sodium Suppository in Treatment of Children with Postoperative Pain

目的研究双氯芬酸钠栓术前塞肛治疗小儿术后疼痛的临床效果。方法选择52例2~8岁行尿道下裂矫治术的患儿,随机分为三组：A组17例手术前使用双氯芬酸钠栓12.5 mg塞肛,B组17例术后立即使用双氯芬酸钠栓12.5 mg塞肛,C组18例不使用双氯芬酸钠栓塞肛。分别记录三组术后0.5、1、2、4、8、16、24小时的FLACC评分、Ramsay镇静评分及术后不良反应发生情况。结果术后各个时间点A组的FLACC评分低于C组,差异有统计学意义（P〈0.05）;术后0.5、1小时A组的FLACC评分低于B组,差异有统计学意义（P〈0.05）;术后1小时后的各时间点B组的FLACC评分都低于C组,差异有统计学意义（P〈0.05）。三组各时间点的Ramsay镇静评分及术后不良反应发生情况无统计学差异（P〉0.05）。结论术前使用双氯芬酸钠栓塞肛能有效治疗小儿术后的疼痛,且安全、经济。

Objective To explore the effect of preemptive analgesia with diclofenac sodium suppository in the treatment of children with postoperative pain.Methods Fifty-two children with surgical repair for hypospadias were randomizedly divided into 3 groups.17 cases of group A used diclofenac sodium suppository 12.5 mg before surgery,17 cases of group B used diclofenac sodium suppository 12.5 mg after surgery immediately,and 18 cases of group C did not use diclofenac sodium suppository.The FLACC score and Ramsay score at 0.5 h,1 h,2 h,4 h,8 h,16 h,and 24 h after surgery and postoperative complications were recorded.Results The FLACC scores of group A were statistically lower than those of group C at each time point（P 0.05）,but only statistically lower than those of group B at 0.5 h and 1 h after surgery（P 0.05）.The FLACC scores of group B were statistically lower than that of group C at 1 h after surgery（P 0.05）.No statistical difference was in Ramsay score at each time point and postoperative complication incidence among 3 groups.Conclusions Preoperative use of diclofenac sodium suppository can effectively reduce the pediatric postoperative pain,and it is safe and economic.